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COVID-19 Updates and Resources

This page will serves as a repository of all COVID-19 emails and resources sent out by KCA. We recognize the significance of this time and are making sure to share ALL correspondence with ALL Kansas Doctors of Chiropractic regardless of membership in KCA.

This page will be updated as we have information and we suggest checking back at least daily for updates.

The following recommendations are based on guidance from Kansas Department of Health and Human Services (KDHE), US Centers for Disease Control (CDC), Centers for Medicare and Medicaid Services (CMS), US Department of Labor Occupational Safety and Health Administration (OSHA), Kansas Office of the Governor, The Joint Commission, and NCMIC Malpractice Insurance Company.

KCA is a professional association advocating for the rights of Chiropractic Physicians and their patients across the state of Kansas. We are not a state agency or regulatory body. You are responsible for understanding and following all rules and regulations from local, state, and federal agencies and regulatory bodies in your office.

Close down your waiting room to patients or arrange it so that all chairs are at least 6 feet apart.

Prior to treating the patient in-office, take their temperature with a non-contact thermometer.

Patients should be in direct contact with staff/providers for as little time as possible to perform the services necessary for their care.

Sanitize all surfaces and wash or sanitize your hands between patients.

Consider accepting non-contact payments in your office.

Only schedule staff in your office if they are required for patient care or to help your office maintain the above guidelines. Other staff should work from home.

A note about masks in Chiropractic practices: CDC Guidelines for Risk Assessment can be used to determine your potential risk associated with exposure to a patient with COVID-19 into either Low, Medium, or High-risk categories. If your exposure is in either the Medium or High-risk category, then CDC guidelines mandate exclusion from work for 14 days after the exposure. If your exposure is in the Low-risk category, then CDC guidelines recommend self-monitoring for symptoms of COVID-19.

As a healthcare provider, wearing a facemask during exposure to a patient with COVID-19 is the difference between a Low-risk exposure and a Medium-High-risk exposure.

Ad Astra Phase 2

All providers, staff, and patients should wear a mask during patient contact. Cloth masks are acceptable.

Some providers are starting to see CARES Act Provider Relief Fund payments in their bank accounts.

The bipartisan CARES Act included the Provider Relief Fund. This is a $30 billion fund that will be allocated to all providers who received Medicare fee-for-service payments in 2019. Providers will be distributed a portion of the initial $30 billion based on their share of total Medicare FFS reimbursements in 2019.

These are payments, not loans, to healthcare providers, and will not need to be repaid.

The automatic payments will come to providers via Optum Bank with "HHSPAYMENT" at the payment description.

Kansas Executive Order No. 20-19

On April 9, 2020, Kansas Gov. Laura Kelly signed Executive Order No. 20-19 extending the deadline for renewing all professional occupational licenses for 90 days past the end of the pandemic emergency.

EO No. 20-19 also extends the deadlines for any continuing education requirements for 90 days past the end of the pandemic emergency.

We don’t expect this Executive Order to affect licenses for Doctors of Chiropractic at this time.

The Kansas Board of Healing Arts has staggered license renewals by provider type through the year and this extension of license expiration dates for other providers may impact the Doctor of Chiropractic renewal period of November 15th through December 31st.

KCA continues to monitor all Executive Orders and works to understand how they will affect your ability to serve the citizens of Kansas with safe, effective chiropractic care.

KCA is currently working on a continuing education plan to address your needed CE hours over the next few months.

March 31, 2020

Title 1 of the CARES Act includes a Small Business Administration Lending program designed to help you maintain your office and your payroll during the COVID-19 crisis.

The SBA loans in this program are 100% guaranteed as opposed to the normal 75% guarantee with SBA loans.

Most small businesses (less than 500 employees) are eligible including sole proprietors, self-employed, and independent contractors.

The covered loan period is February 15, 2020, through June 30, 2020, but to take advantage of the full amount of the loan your application should be completed and funded by April 30, 2020.

Loan amounts are determined by your average monthly payment on payroll, including 1099 employees (contractors), over the last 12 months x 2.5.

Loan authority approval is delegated to the bank to speed the approval process and interest is capped at 4%. Interest will be deferred at least 6 months and up to 12 months. Repayment is over a minimum of 10 years.

You have the possibility for loan forgiveness if you keep your employees on payroll for the 8-week period of May and June 2020, and you only use the funds for approved purposes.

Borrowers will not be required to pledge any collateral or provide a personal guarantee to secure or support a Paycheck Protection Loan.

The SBA will not charge any fees on loans through this program, but participating lenders are entitled to charge a percentage-based fee up to 5% of the loan proceeds.

This information is complex and KCA recommends you contact a tax attorney or an accountant for advice. We are presenting this to you for informational purposes only. KCA employees and officers are not qualified to give tax or accounting advice and will not give tax or accounting advice.

March 30, 2020

Earlier this week, the American Chiropractic Association sent a letter to the Department of Homeland Security asking for clarification on the issue of whether or not Doctors of Chiropractic are essential providers during the COVID-19 pandemic. Over the weekend the Department of Homeland Security issued an updated list of essential critical infrastructure that included Doctors of Chiropractic. The memorandum can be viewed online.

This “Stay Home” order follows the Kansas Essential Function Framework from Executive Order No. 20-15 signed on March 24, 2020.

EO No. 20-16 requires “all individuals within the state of Kansas” to “stay in their homes or residences unless performing as essential activity.”

Included among the essential activities are:

Performing, or going to or from work at a business or organization to perform, an essential function as identified in the Kansas Essential Function Framework

Seeking medical care

EO No. 20-16 supersedes all local “stay home” orders.

Additionally, EO No. 20-16 states:

“No individual leaving their home in order to perform an activity or function allowed under this order shall be required to carry or present any letter, identification card, or other paper proving they are allowed to leave their home…”

KCA maintains that Doctors of Chiropractic are included in the Kansas Essential Functions Framework outlined in EO No. 20-15 and you may continue to see patients in-person for medically necessary care as long as you are able to maintain CDC and KDHE guidelines. See KCA Recommendations above.

March 27, 2020

Kansas Updates Mandated Quarantine Rules to include travel to Louisiana or anywhere in Colorado on or after March 27th.

Local authorities must grant – and do not have the discretion to deny – exemptions from the restrictions of any local “stay home” or similar order to requesting companies or other organizations for the performance of the following essential functions…

Under the heading KEFF 300 MANAGE is #20. Provide Medical Care and Services, including Mortuary Services.

It is our understanding that Doctors of Chiropractic and Chiropractic offices would fall under this exemption. Therefore, any local Stay-at-Home order must exempt Chiropractic offices and allow them to see patients. We continue to recommend the office procedures outlined on this page to help stop the spread and limit exposure.

Many municipalities and counties in Kansas are issuing “Stay-at-Home Orders.” These orders are typically very similar, but you should make sure to carefully read any order for your jurisdiction(s) and make sure you understand the language and implications of the order.

“Stay-at-Home Orders” are implemented in order to help stop the spread of COVID-19. While the orders that the KCA has reviewed all make an exemption for “healthcare operations” it is important that your office do its part to help stop the spread also.

If you practice in a location that allows you to continue to see patients in person and you choose to remain open, you must take every precaution necessary to see patients safely.

KCA continues to recommend the following practices to help stop the spread

See patients in your office for medically necessary care only – all other patients can be seen through a telemedicine service. Many insurance providers have relaxed their telehealth restrictions and requirements.

Reschedule, or do not schedule, patients who are on maintenance care, have pre-existing lung diseases, or other co-morbidities.

Pre-screen all patients by phone prior to seeing them in your office using the KDHE recommendations for mandated quarantine (most recent 3-19-2020)

Pre-screen all patients by phone for symptoms prior to seeing them in your office - ask about COVID-19 symptoms: fever, cough, or shortness of breath and their current complaints to determine if treatment may be medically necessary

Close down your waiting room to patients.

Pre-screened patients should wait in their vehicles until called into the office by staff and should go directly to the treatment rooms.

Prior to treating the patient in-office, take their temperature with a non-contact thermometer. Do not treat any patient with a forehead temperature above 99.4 degrees Fahrenheit. We do not recommend taking oral temperatures as this increases risk of exposure to COVID-19.

Patients should be in contact with as few people as possible during their visit and should be in the office for less than 20 minutes. Ideally, they should only be in contact with the doctor and out of the office within 10 minutes.

Sanitize all surfaces and wash or sanitize your hands between patients.

Consider billing patients by mail instead of collecting at the time of service.

Consider a work from home option for your staff. They can answer phones from home, schedule patients, and perform billing functions.

KCA believes the question of whether you should close your clinic or modify your practice hours is up to you as a Doctor of Chiropractic. KCA recognizes that chiropractic care is an essential part of your patients’ overall health and well-being and your safety, as well as that of your patients and staff, is the No. 1 priority.

KCA continues to monitor the situation and will let members know about any changes as we hear them.

March 23, 2020

Kansas Board of Healing Arts issues Guidance Statements on COVID-19

Over the weekend, the KSBHA issued a Guidance Statement concerning COVID-19. This statement covers temporary licensing changes included expedited practice options for as well as the following guidance statement:

BOARD GUIDANCE STATEMENTS TO ALL KANSAS PRACTITIONERS:

Technical violations of the Healing Arts Act or other applicable practice act by healthcare providers that do not endanger or defraud the public, which are committed in the course of good faith COVID-19 response efforts during the Kansas emergency declaration period, will generally not be treated as a disciplinary matter by the Board.

In the context of violations (not involving gross negligence, serious danger to patient or public safety, misleading or deceptive conduct, unethical conduct, or fraud) of the Healing Arts Act or other applicable practice act by healthcare providers in the course of good faith COVID-19 response efforts, the Board will consider the fact that the provider committed the violation in the course of good faith participation in COVID-19 response efforts to be a significant mitigating factor in the event a complaint is filed against the provider for such violation.

The Board will consider violations of any mandatory quarantine provisions issued by the KDHE, Governor, or CDC that are both willful and substantive to constitute unprofessional conduct if the licensee continues to interact with patients or other healthcare providers in violation of such mandates.

If the Board finds that any licensee has fraudulently or unethically taken advantage of the COVID-19 crisis for personal gain in a manner that constitutes unprofessional conduct under the Healing Arts Act, the Board will consider such conduct to be an aggravated violation of the Healing Arts Act or other applicable practice act and will exercise its full authority to impose discipline for such conduct, including suspension or revocation.

March 20, 2020

KCA Members – Unemployment Options for your Employees

Please be aware that your employees may be eligible for unemployment benefits if your office either closes or reduces hours due to COVID-19

The Kansas Department of Labor https://www.dol.ks.gov/ has a number of resources to help you and your staff through this process. Their COVID-19 Resource Page is a good place to start.

You also have the option to utilize the Shared Work Program if you staff hours are reduced, but not eliminated due to COVID-19. This allows your staff to continue to work and receive some unemployment benefit.

The Kansas Department of Labor has a Fact Sheet on COVID-19 that may help answer any questions you or your staff might have.

Please remember that if you reduce or eliminate employee hours you are required to notify employees that they may be eligible for unemployment benefits.